Tooth Extractions

Dental Extraction Fresno CA

Tooth Extraction

A tooth that is severely damaged may need to be removed. A surgeon who specializes in surgeries of the mouth (oral and maxillofacial surgeon) or your dentist can remove a tooth.
Before removing your tooth, your dentist will give you a local anesthetic to numb the area where the tooth will be removed. A stronger, general anesthetic may be used, especially if several or all of your teeth need to be removed. General anesthetic prevents pain in the whole body and will make you sleep through the procedure.
Saliva and Your Mouth
Saliva is a clear, watery liquid made by several glands in your mouth area. Saliva is an important part of a healthy body. It is mostly made of water. But saliva also contains important substances that your body needs to digest food and keep your teeth strong. Saliva is important because it: Keeps your mouth moist and comfortable Helps you chew, taste, and swallow Fights germs in your mouth and prevents bad breath Has proteins and minerals that protect tooth enamel and prevent tooth…
After the tooth is removed, you may need stitches. You can gently bite down on a cotton gauze pad placed over the wound to help stop the bleeding. The removed tooth can be replaced with an implant, a denture, or a bridge. A bridge is a replacement for one or more (but not all) of the teeth and may be permanent or removable.

What to Expect After Surgery

In most cases, the recovery period lasts only a few days. The following will help speed recovery:

• Take painkillers as prescribed by your dentist or oral surgeon.
• After 24 hours, rinse your mouth gently with warm salt water several times a day to reduce swelling and relieve pain. Make your own salt water by mixing 1 tsp. (5 g) of salt in a medium-sized glass [8 fl oz (237 mL)] of warm water.
• Change gauze pads before they become soaked with blood.
• Relax after surgery. Physical activity may increase bleeding.
• Avoid smoking.
• Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.
• Do not lie flat. This may prolong bleeding. Prop up your head with pillows.
• Avoid rubbing the area with your tongue.
• Continue to carefully brush your teeth and tongue.

After the tooth is removed, you may need stitches. Some stitches dissolve over time, and some have to be removed after a few days. Your dentist will tell you whether your stitches need to be removed.

Why It Is Done

Removing a tooth is necessary when decay or an abscessed tooth is so severe that no other treatment will cure the infection.

How Well It Works

Removing the tooth can help keep infection from spreading to other areas of your mouth.

Risks

Some dental work can cause bacteria in the mouth to enter the bloodstream and cause infections in other parts of the body. People who have a hard time fighting off infections may need to take antibiotics before and after dental surgery. Such people include those who have artificial heart valves and those who were born with heart defects.

What to Think About

A tooth extraction should be done as soon as possible to avoid the spread of infection and more serious problems. In cases in which a root canal treatment might not save the tooth, your dentist may recommend that the tooth be removed and a bridge or implant installed.
Pulling a Tooth 
When you were 6, losing a tooth was a rite of passage, perhaps achieved by incessant tooth jiggling, biting into a crisp apple, or tying a string around the tooth and giving it a tug. As an adult, tooth loss is hardly cause for celebration, yet having a tooth pulled is sometimes necessary.
Reasons for Pulling Teeth
Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be needed. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired. Other reasons include:
A crowded mouth :  Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth for it, your dentist may recommend pulling it.
Infection:  If tooth decay or damage extends to the pulp — the center of the tooth containing nerves and blood vessels — bacteria in the mouth can enter the pulp, leading to infection. Often this can be corrected with root canal therapy (RCT), but if the infection is so severe that antibiotics or RCT do not cure it, extraction may be needed to prevent the spread of infection.
Risk of infection: If your immune system is compromised (for example, if you are receiving chemotherapy or are having an organ transplant) even the risk of infection in a particular tooth may be reason enough to pull the tooth.
Periodontal (Gum) Disease: If periodontal disease — an infection of the tissues and bones that surround and support the teeth — have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth.
What to Expect With Tooth Extraction
Dentists and oral surgeons (dentists with special training to perform surgery) perform tooth extractions. Before pulling the tooth, your dentist will give you an injection of a local anesthetic to numb the area where the tooth will be removed. If you are having more than one tooth pulled or if a tooth is impacted, your dentist may use a strong general anesthetic. This will prevent pain throughout your body and make you sleep through the procedure.
If the tooth is impacted, the dentist will cut away gum and bone tissue that cover the tooth and then, using forceps, grasp the tooth and gently rock it back and forth to loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces.
Once the tooth has been pulled, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and have you bite down on it to help stop the bleeding. Sometimes the dentist will place a few stitches — usually self-dissolving — to close the gum edges over the extraction site.
Sometimes, the blood clot in the socket breaks loose, exposing the bone in the socket. This is a painful condition called dry socket. If this happens, your dentist will likely place a sedative dressing over the socket for a few days to protect it as a new clot forms.
What to Tell Your Dentist Before You Have a Tooth Pulled
Although having a tooth pulled is usually very safe, the procedure can allow harmful bacteria into the bloodstream. Gum tissue is also at risk of infection. If you have a condition that puts you at high risk for developing a severe infection, you may need to take antibiotics before and after the extraction. Before having a tooth pulled, let your dentist know your complete medical history, the medications and supplements you take, and if you have one of the following:

• damaged or man-made heart valves
• congenital heart defect
• impaired immune system
• liver disease (cirrhosis)
• artificial joint, such as a hip replacement
• history of bacterial endocarditis

After You’ve Had a Tooth Pulled
Following an extraction, your dentist will send you home to recover. Recovery typically takes a few days. The following can help minimize discomfort, reduce the risk of infection, and speed recovery.

• Take painkillers as prescribed.
• Bite firmly but gently on the gauze pad placed by your dentist to reduce bleeding and allow a clot to form in the tooth socket. Change gauze pads before they become soaked with blood. Otherwise, leave the pad in place for three to four hours after the extraction.
• Apply an ice bag to the affected area immediately after the procedure to keep down swelling. Apply ice for 10 minutes at a time.
• Relax for at least 24 hours after the extraction. Limit activity for the next day or two.
• Avoid rinsing or spitting forcefully for 24 hours after the extraction to avoid dislodging the clot that forms in the socket.
• After 24 hours, rinse with your mouth with a solution made of 1/2 teaspoon salt and 8 ounces of warm water.
• Do not drink from a straw for the first 24 hours.
• Do not smoke, which can inhibit healing.
• Eat soft foods, such as soup, pudding, yogurt, or applesauce the day after the extraction. Gradually add solid foods to your diet as the extraction site heals.
• When lying down, prop your head with pillows. Lying flat may prolong bleeding.
• Continue to brush and floss your teeth, and brush your tongue, but be sure to avoid the extraction site. Doing so will help prevent infection.

When to Call the Dentist
It is normal to feel some pain after the anesthesia wears off. For 24 hours after having a tooth pulled, you should also expect some swelling and residual bleeding. However, if either bleeding or pain is still severe more than four hours after your tooth is pulled, you should call your dentist. You should also call your dentist if you experience any of the following:

• Signs of infection, including fever and chills or vomiting Redness, swelling, or excessive discharge from the affected area Cough, shortness of breath, chest pain, or severe nausea or vomiting

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Long-term, however, having a tooth (or teeth) missing can cause the remaining teeth to shift, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth with an implant, fixed bridge, or denture.